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Aggressive incidents in first-episode psychosis

East Midlands Centre for Forensic Mental Health, Leicester

SHAZAD AMIN, MRCPsych

Moorside, Trafford General Hospital, Manchester

SWARAN P. SINGH, MRCPsych

Division of Psychiatry, University of Nottingham, Nottingham

GLYNN HARRISON, FRCPsych

Division of Psychiatry, University of Bristol, Bristol

PETER JONES, MRCPsych, TIM CROUDACE, PhD, IAN MEDLEY, MRCPsych and JOHN BREWIN, MRCPsych

Division of Psychiatry, University of Nottingham, Nottingham, UK

Correspondence: Dr John Milton, East Midlands Centre for Forensic Mental Health, Arnold Lodge, Cordelia Close, Leicester LE5 OLE, UK. Tel: 0116 225 6060; Fax: 0116 225 6061; e-mail: John.Milton{at}arnoldl.cnhc-tr.trent.nhs.uk

Declaration of interest Support was received from the National Health Service Executive (Trent Research & Development).

Background Recent research has reported increased risk of aggressive incidents by individuals with psychotic illness.

Aims To examine acts of aggression in first-episode psychosis.

Method Subjects with a first-episode psychosis were ascertained from a defined catchment area (Nottingham, UK) and reassessed at 3 years (n=166) using clinical interview, informants, health care and forensic records.

Results Of the subjects, 9.6% demonstrated at least one act of serious aggression (defined as weapon use, sexual assault or victim injury) during at least one psychotic episode and 23.5% demonstrated lesser acts of aggression (defined as all other acts of aggression). For all aggressive subjects (33.1%), unemployment (OR=3.6, 95% C11.6-8.0), comorbid substance misuse (OR=3.1, C1 1.1-8.8) and symptoms of overactivity at service contact (OR=6.9,C1 2.7-17.8) had independent effects on risk of aggression.

Conclusions We confirmed some previously reported demographic and clinical associations with aggression in first-episode psychosis but no relationship with specific psychotic symptoms or diagnostic groups was observed.

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